Topical emollients and anti-inflammatory drugs are key remedies for atopic dermatitis (AD). We examined the effects of heparinoid moisturizer (Hirudoid®lotion 0.3%) on the clinical effectiveness and irritability of topical tacrolimus. Half side comparative application study was conducted on two affected area, namely face and trunk/extremities, in seventeen patients with AD (15 moderate cases, 2 severe cases) ; right side was applied once a day with Protopic®ointment 0.1% only (Tacro group), and left side with Hirudoid®lotion 0.3% + Protopic®ointment 0.1% (Hirud + Tacro group) for 2 weeks. Skin severity was evaluated by 5-grade scores ; 0: none, 1: mild, 2: moderate, 3: severe, 4 very severe. Irritability of topical tacrolimus was evaluated by 5-grade scores ; 1: very strong irritation, 2: strong irritation, 3: mild irritation, 4: almost no irritation, 5: no irritation. Significant improvement was observed in skin severity after 2 weeks treatment both in Tacro group and Hirud + Tacro group, and the clinical efficacy of Tacro group was similar to Hirud + Tacro group. As for the tacrolimus-associated irritation after 1-week application, 5 patients reported their irritation as Hirud + Tacro < Tacro, 12 as Hirud + Tacro = Tacro, and 0 as Hirud + Tacro > Tacro. These results prove that topical application of Hirudoid®lotion 0.3% does not weaken the clinical efficacy of Protopic®ointment 0.1%. Moreover, Hirudoid®lotion 0.3% may be feasible to reduce the tacrolimusassociated skin irritation in a part of AD patients.
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